Browse by author
Lookup NU author(s): Professor John LeedsORCiD, Dr Manu Nayar, Professor Kofi Oppong
Full text for this publication is not currently held within this repository. Alternative links are provided below where available.
© 2021. Background and Aims: EUS-guided choledochoduodenostomy (EUS-CDD) with an electrocautery-enhanced lumen-apposing metal stent (EC-LAMS) has emerged as a viable method of establishing biliary drainage in patients with malignant distal biliary obstruction (MDBO). Our aim was to assess the efficacy, safety, and outcomes in patients with MDBO who underwent EUS-CDD with an EC-LAMS. Methods: A retrospective review of consecutive patients with MDBO who underwent EUS-CDD with EC-LAMSs at 8 tertiary institutions across the United Kingdom and Ireland between September 2016 and November 2020 was undertaken. Results: One hundred twenty patients (55% men) with a median age of 73 years (interquartile range, 17; range, 43-94) were included. The median follow-up period in 117 patients was 70 days (interquartile range, 169; range, 3-869), and 23 patients (19.2%) were alive at the end of the follow-up. Three patients were lost to follow-up. Technical success was achieved in 109 patients (90.8%). Clinical success (reduction of serum bilirubin to ≤50% of original value within 14 days) was achieved in 94.8% of patients (92/97). The adverse event rate was 17.5% (n = 21). Biliary reintervention after initial technical success was required in 9 patients (8.3%). Conclusions: EUS-CDD with EC-LAMSs at tertiary institutions within a regional hepatopancreatobiliary network for treatment of MDBO was effective in those where ERCP was not possible or was unsuccessful. When technical failures or adverse events occur, most patients can be managed with conservative or endoscopic therapy.
Author(s): On W, Paranandi B, Smith AM, Venkatachalapathy SV, James MW, Aithal GP, Varbobitis I, Cheriyan D, McDonald C, Leeds JS, Nayar MK, Oppong KW, Geraghty J, Devlin J, Ahmed W, Scott R, Wong T, Huggett MT
Publication type: Article
Publication status: Published
Journal: Gastrointestinal Endoscopy
Year: 2022
Volume: 95
Issue: 3
Pages: 432-442
Print publication date: 01/03/2022
Online publication date: 09/10/2021
Acceptance date: 27/09/2021
ISSN (print): 0016-5107
ISSN (electronic): 1097-6779
Publisher: Elsevier Inc.
URL: https://doi.org/10.1016/j.gie.2021.09.040
DOI: 10.1016/j.gie.2021.09.040
PubMed id: 34637805
Altmetrics provided by Altmetric